anatomical pathology: pancreas Flashcards
How does insulin allow for glucose to enter the cell
- Insulin binds to receptor on cell membrane
- Secondary messenger system is activated
- Translocation of GLUT-4 vesicle to cell membrane
- Allow for glucose molecules to enter the cell
What is the four clinical features of diabetes
- Fasting hyperglycemia
- Glucosuria
- Micro- & macroangiopathy
- Neuropathy
What is the GLUT-1 transporter
Allows glucose to enter the cell without action of insulin leading to uncontrolled glucose uptake & damage
Where is the GLUT-1 transporter
Endothelium, eyes, nerves & kidney
What is type 1 diabetes
Pancreas failure to produce insulin
What is type 2 diabetes
Cells fail to respond to insulin & early hyperinsulinism
What is the aetiology in type 1 diabetes
Inheritable & autoimmune
What is the aetiology in type 2 diabetes
Obesity & other proposed theories
What is the pathogenesis of type 1 diabetes
Environmental trigger like an infection causes immune response to produce anti-islet antibodies & HLA associated pancreatic B cell damage
What is the four mechanism of complication in diabetes
- Advanced glycation end products
- Activation of protein kinase C
- Sorbitol & fructose
- Excess oxygen free radical
What is ment by advanced glycation end products
Increased glucose causes glucose to bind with proteins in the vascular in excess that causes protein conformational changes & cause damage
Decreases the elasticity & increases the basement membrane thickness
What is ment by activation of protein kinase C
Due to hyperglycemia intracellular enzyme gets activated causing angiogenesis
What does accumulation of sorbitol cause
Swelling
What is the acute complication of diabetes
Coma either due to hypo- or hyperglycemia
What is the four chronic complications in diabetes
- Microvascular complication
- Macrovascular complications
- Neuropathy
- Increased infection risk
What five things are seen at the eye with the fundoscope in diabetic patients
- Cotton wool spots
- Angiogenesis
- Aneurysms
- Haemorrhage
- Hard exudate
What four changes occur in the kidney due to diabetes
- Kimmelstiel Wilson lesions
- Thickening of basement membrane causing proteinuria
- Pyelonephritis
- Renal papillary necrosis
What is a macrovascular complication of diabetes
Earlier onset of atherosclerosis
What is the three risks of atherosclerosis
- Stroke
- Peripheral vascular disease
- Coronary heart disease
What is the nerves blood supply
Vasa nervosum
What is the autonomic nervous systems complications
Diarrhea, abdominal pain & hypotension
What is diabetic foot
Combination of neuropathy & angiopathy with increased susceptibility to infection because of hyperglycaemia
